Same day discharge following programed PCI with no complications has been a way for health centers to reduce costs that has resulted both safe and convenient for patients.
With the arrival of the pandemic, reduced bed capacity, uninfected patient exposure and their potential contagion, and the always pressing need to reduce hospital costs have turned same day discharge into a necessity for many centers.
Fortunately, the evidence on safety of same day discharge had already been shown before COVID-19, and the latter has made many operators feel they needed to implement it.
This study included 819,091 patients undergoing programed PCI in 1,716 centers. It looked at the link between same day discharge and 30-day mortality in addition to rehospitalization.
In this series, 14% were discharged the same day, though the proportion increased at followup: it went from a mere 4.5% at the beginning to almost 30% towards the end. This percentage grew according to an increased use of the transradial approach instead of the femoral.
Mortality at 30 days resulted identical throughout the followup period, even though the adjusted risk of rehospitalization dropped, and this effect was more significative for patients discharged the same day (p for interaction <0.001).
Read also: AHA 2020 | Rise in Early Discharge After TAVR Has the Expected Cost.
This strategy of established safety (together with the transradial approach) can be an effective tool to keep doing programed PCI procedures during the pandemic.
Conclusion
Same day discharge after elective PCI has been on the rise since the beginning of this practice. Mortality has not been compromised and re-hospitalization has actually dropped, which confirms the safety of this strategy.
In pandemic times, same day discharge might have some perks.
Original Title: Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention.
Reference: Steven M Bradley et al. JACC Cardiovasc Interv. 2021 Aug 9;14(15):1655-1666. doi: 10.1016/j.jcin.2021.05.043.
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